A “Strong Intervention”: How Personalized Music Helped Lemon Grove Cut Antipsychotic Use in Half

Whenever Judy Ely sits down with a new resident at the Lemon Grove Care Center to learn about his or her favorite foods, she also asks about a different sort of preference: What kind of music do you love?

Director of Dietary Services for the San Diego long-term-care and rehabilitation complex, Ely is the driving force behind the 152-resident facility’s Music & Memory iPod program.

“I speak to our residents every day,” says Ely. “I know how much it would mean to me, to be able to hear my personal music favorites if I lived here. The iPod program is part of our company’s ongoing efforts to make a positive difference in the lives of our residents.”

50 Percent Reduction in Use of Antipsychotics

Lemon Grove’s personalized music program is also part of the organization’s response to an initiative by the Centers for Medicare and Medicaid Services (CMS) to improve the lives of nursing home residents by reducing the unnecessary use of antipsychotic drugs for individuals with dementia. Launched in March 2012, the CMS initiative called for a 15 percent reduction in off-label antipsychotic drug use by the end of the calendar year.

Lemon Grove has far surpassed that goal, reducing use of antipsychotics by 50 percent in 2012. According to Toni Alexander, Director of Nursing, the Music & Memory personalized music program is a “strong intervention,” one of several initiatives that have contributed to the care facility’s ability both to reduce dosage levels as well as the number of antipsychotics taken by individual residents with a wide variety of mental health issues. She adds that use of these medications at Lemon Grove continues to decline.

Judy Ely concurs that iPods loaded with residents’ personal favorites definitely seem to be making a difference in antipsychotic use. “Gradual dose reductions are more successful with the personalized music than without,” she says.

“A Powerful Antidote to Depression”

The Music & Memory program’s success at Lemon Grove caught the attention of the California Association of Health Facilities (CAHF), which made a video last year to promote it. CAHF is part of a collaborative with CMS and the California Department of Public Health to reduce the unnecessary use of antipsychotics in nursing homes. This year’s goal is a 30 percent reduction by June 2013.

“CAHF supports this unique program,” says CAHF’s Deborah Pacyna. “Music, especially personalized music, is a powerful antidote to depression and loneliness and a comfort to many of our residents.”

Reaping the Benefits of Personalized Music

Ely received her training through Music & Memory’s Webinar Certification Program, after she heard an activities consultant describe the benefits of personalized music. She built Lemon Grove’s music library using existing CDs from the activities department and iTunes downloads as well as borrowed music from a variety of sources.

With 50 iPods acquired for the facility as a benefit of the training program, Ely now has two dedicated volunteers–a former classical music DJ and an expert in scoring screenplays–who help her to develop personalized playlists for residents.

The benefits are quite striking.

To cite just one example, Ely brightens as she tells the story of a new elderly resident whose health issues have impaired her ability to interact with the world.

“She used to work in Los Angeles,” says Ely. “In the ’50s, she loved to go to the Palladium with her husband.” There they danced to the champagne music of Lawrence Welk. The woman also sang in her church choir and remembers her grandparents waltzing to a Norwegian melody when she was a small child.

Volunteers Play Key Role in Program’s Success

“She was pretty agitated at first,” says Ely. “But as my volunteer spoke with her, she remembered many details about her childhood.”

From that conversation, the volunteer developed suggestions for a personalized playlist that included Welk’s tunes, religious favorites and even some Norwegian folksongs that recalled the waltz the woman used to hear at her grandparents’ home.

Her response was enthusiastic: “She was so happy,” says Ely. “She said, ‘Oh, this is the music that I like!’”

Ely is buoyed by her volunteer team and support from many staff members throughout the facility who help her to find music and learn about new resources. Most of all, she treasures her interactions with residents. “We’re scoring their lives,” she says.

The time commitment is both manageable and well worth the benefits. “It’s all about being kind, taking the time to be kind,” she says. “Music enables that time. I’ve learned so much. It’s an amazing gift.”